Domain 8: Informatics and Healthcare Technologies

Domain 8: Informatics and Healthcare Technologies

Descriptor: Information and communication technologies and informatics processes are used to provide care, gather data, form information to drive decision making, and support professionals as they expand knowledge and wisdom for practice. Informatics processes and technologies are used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practice and professional and regulatory standards. 

Contextual Statement: Healthcare professionals interact with patients, families, communities, and populations in technology-rich environments. Nurses, as essential members of the healthcare team, use information and communication technologies and informatics tools in their direct and indirect care roles. The technologies, the locations in which they are used, the users interacting with the technology, the communication occurring, and the work being done all impact the data collected, information formed, decisions made, and the knowledge generated. Additionally, the utilization of information and communication technologies in healthcare settings changes how people, processes, and policies interact. Using these tools in the provision of care has both short- and long-term consequences for the quality of care, efficiency of communications, and connections between team members, patients, and consumers. It is essential that nurses at all levels understand their role and the value of their input in health information technology analysis, planning, implementation, and evaluation. With the prevalence of patient-focused health information technologies, all nurses have a responsibility to advocate for equitable access and assist patients and consumers to optimally use these tools to engage in care, improve health, and manage health conditions. 

8.1 Describe the various information and communication technology tools used in the care of patients, communities, and populations. 

8.1g Identify best evidence and practices for the application of information and communication technologies to support care. 

8.1h Evaluate the unintended consequences of information and communication technologies on care processes, communications, and information flow across care settings. 

8.1i Propose a plan to influence the selection and implementation of new information and communication technologies. 

8.1j Explore the fiscal impact of information and communication technologies on health care. 

8.1k Identify the impact of information and communication technologies on workflow processes and healthcare outcomes. 

8.2 Use information and communication technology to gather data, create information, and generate knowledge. 

8.2f Generate information and knowledge from health information technology databases. 

8.2g Evaluate the use of communication technology to improve consumer health information literacy. 

8.2h Use standardized data to evaluate decision-making and outcomes across all systems levels. 

8.2i Clarify how the collection of standardized data advances the practice, understanding, and value of nursing and supports care. 

8.2j Interpret primary and secondary data and other information to support care. 

8.3 Use information and communication technologies and informatics processes to deliver safe nursing care to diverse populations in a variety of settings. 

8.3g Evaluate the use of information and communication technology to address needs, gaps, and inefficiencies in care. 

8.3h Formulate a plan to influence decision-making processes for selecting, implementing, and evaluating support tools. 

8.3i Appraise the role of information and communication technologies in engaging the patient and supporting the nurse-patient relationship. 

8.3j Evaluate the potential uses and impact of emerging technologies in health care. 

8.3k Pose strategies to reduce inequities in digital access to data and information. 

8.4 Use information and communication technology to support documentation of care and communication among providers, patients, and all system levels. 

8.4e Assess best practices for the use of advanced information and communication technologies to support patient and team communications. 

8.4f Employ electronic health, mobile health, and telehealth systems to enable quality, ethical, and efficient patient care. 

8.4g Evaluate the impact of health information exchange, interoperability, and integration to support patient-centered care. 

8.5 Use information and communication technologies in accordance with ethical, legal, professional, and regulatory standards, and workplace policies in the delivery of care. 

8.5g Apply risk mitigation and security strategies to reduce misuse of information and communication technology. 

8.5h Assess potential ethical and legal issues associated with the use of information and communication technology. 

8.5i Recommend strategies to protect health information when using communication and information technology. 

8.5j Promote patient engagement with their personal health data. 

8.5k Advocate for policies and regulations that support the appropriate use of technologies impacting health care. 

8.5l Analyze the impact of federal and state policies and regulation on health data and technology in care settings. 

(American Association of Colleges of Nursing, 2021, pp. 46-48)

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACNnursing.   https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Related Evidence

 For the NURS 7112: Healthcare Informatics course, I was assigned to write a paper aimed at exploring the impact, potential legal and ethical concerns, and implications of the use of provider-centered mobile health technologies. I chose to focus this paper on the Epocrates platform due to my previous use of the free version of the application (app). Before writing this paper, I performed an extensive literature search to learn of any legal or ethical concerns related to the use of this app. No legal concerns were noted; however, the search revealed some ethical concerns. The first concern was that junior providers relying on the information provided by the app may lack the experience to recognize if the provided information is accurate (Sharp & O’Sullivan, 2017). However, a systematic review and meta-analysis by Maggio et al. (2019) found that electronic information sources such as Epocrates were significantly associated with improved clinician behaviors and patient outcomes. The second concern was related to the appearance of pharmaceutical advertisements on the app's free version (Grundy et al., 2019).

As I previously mentioned, Epocrates is available as a free medical reference app that includes a pharmacology reference; formulary; and various support tools, such as a pill identifier, an interaction checker, and an array of calculators and tables (Harriet F. Ginsburg Health Sciences Library, n.d.). Additionally, Epocrates offers an expanded version of this mobile technology to users subscribing to a paid annual membership (GetApp, n.d.). The paid version grants the user access to all the tools and features included in the basic (free) version, plus disease information, diagnosis, alternative medicine, current procedural terminology, and ICD-10 codes (Harriet F. Ginsburg Health Science Library, n.d.). As I stated earlier, I had used the free version of Epocrates throughout my nursing career and found it very helpful. After writing this paper, I purchased the subscription for the expanded application despite the associated cost.

 For the NURS: 7112: Healthcare Informatics course, I wrote a paper regarding Meaningful Use, which is a program created by the Centers for Medicare and Medicaid Services for the purpose of financially incentivizing clinics, providers, and hospitals to utilize electronic health records (EHRs) to achieve specific health and efficiency goals (Anumula & Sanelli, 2012). The three components of Meaningful Use are the use of the certified EHR in a meaningful fashion, the electronic exchange of health information for improving patient care, and the submission of clinical quality measures for monitoring (CMS, 2010). Although Meaningful Use has multiple core objectives, this paper focused on the objectives of E-prescribing and medication reconciliation and their effects on provider practice and patient and quality outcomes. The findings of this paper revealed that Meaningful Use enabled entities to collect and effectively transmit essential information from provider to provider, giving caregivers the tools they need to improve efficiency, safety, and patient outcomes.

Reflection

The paper on Epocrates was highly beneficial because it opened my eyes to the various support tools available to providers. While I remain cognizant that this technology cannot replace didactic learning and guidance from seasoned providers, I have found it to be extremely helpful in my clinical rotations and frequently utilize the many tools available in this app. This paper aided in my achievement of Domains 8.1, “Describe the various information and communication technology tools in the care of patients, communities, and populations,” 8.4f, “Employ electronic health, mobile health, and telehealth systems to enable quality, ethical, and efficient patient care" (American Association of Colleges of Nursing, 2021, pp. 46-48).

 The paper on Meaningful Use was beneficial because it shifted my viewpoint on the use of EHRs. When I began my nursing career in the early 2000s, charting was primarily paper-based. Additionally, many psychiatric facilities I have worked at over the years are small and have largely maintained the paper charting format. Therefore, my experience with EHRs has been minimal and challenging, leading to a personal bias against EHRs. However, after researching the impact of EHRs on workflow efficiency, safety, and patient outcomes, I acknowledge the fact that these tools have proven to be very beneficial to the field of healthcare. Additionally, I have had the opportunity to use EHRs extensively during my clinical rotations and found them to be especially useful in my practice as a student psychiatric mental health nurse practitioner.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. AACNnursing.   https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf